Coding Integrity Specialist Jobs in Delaware (NOW HIRING)

Do you want to work at one of the Top 100 Hospitals in the nation? We are guided by our values ofLoveandExcellenceand are passionate about delivering health, not just health care. Come join us at ChristianaCare!

PRIMARY FUNCTION:

Provides operational oversight for HIMS (Health Information Management Services) coding data quality monitoring and coder education activities to support the accuracy, integrity, productivity, and compliance of coded data in alignment with organizational, regulatory, and reimbursement objectives. Supports the implementation and coordination of coder onboarding, ongoing education, and retraining initiatives, using quality reviews, audit findings, and performance outcomes to reinforce coding standards, address knowledge gaps, and promote continuous improvement in coding performance. Functions as a member of the Coding Management team, providing leadership support and serves as a backup to the Manager of Coding Data Management & Coder Education.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Provides daily supervision and oversight of the coding data accuracy and coder education functions across inpatient and outpatient hospital coding and abstracting activities within HIMS. Acts under the direction of the Manager of Coding Data Management and Coder Education with responsibility for all duties and accountabilities of the staff.

Monitors coding accuracy, productivity, staffing levels, schedules, and workload distribution to meet month-end close activities and departmental performance goals.

Performs or assigns record review activities related to prebill edit resolution, internal coding audits, and responses to internal or external audit requests (e.g., RAC, OIG, Internal Audit, Compliance) or coding accuracy validation requests.

Utilizes reporting tools and database queries to perform audits, monitor trends, and support process improvements.

Monitors and supports billing edit work queues and coordinates correction activities with Patient Financial Services to support timely resolution of accounts requiring HIMS coding review.

Assists with coding and related system analysis, implementation, testing, database management, application maintenance, troubleshooting, regulatory compliance, data accuracy, and system security for coding and abstracting applications and interfaces.

Collaborates with Medical-Dental Staff, Clinical Documentation Improvement (CDI) Specialists, Patient Financial Services, and other departments to address operational coding, documentation, and reimbursement issues and to support identified education needs.

Provides day-to-day guidance to coders regarding coding questions, workflow processes, and system use, escalating complex issues to the Senior Manager, as appropriate.

Coordinates orientation activities for newly hired coders, coding contractors, and Coding Associates including training on the ChristianaCare medical record, coding systems, reference applications, and HIMS coding workflows.

Supports Coding Education Coordinators by assisting with coder mentoring activities, monitoring coding questions and trends, and reinforcing education provided through training programs.

Assists in preparation and coordination of coding staff meetings, including distribution of educational materials related to coding regulations, regulatory updates, system enhancements, and documentation practice changes.

Tracks operational metrics related to coder education activities, appeals outcomes, and workflow performance, and reports findings to the Senior Manager to support program oversight.

Maintains documentation related to coder education activities, training completion, and operational procedures to support consistency and compliance.

Assists with identification of coder education needs based on coding questions, workflow challenges, and feedback from quality reviews or appeals outcomes.

Conducts quarterly touchbases with staff and provides input on employee selection, development, training, promotion, and corrective action, including participating in disciplinary or discharge actions as appropriate.

Contributes to the development of departmental goals and objectives and participates in projects assigned by the HIMS Management Team to support departmental and organizational priorities.

SCOPE, PURPOSE, AND FREQUENCY OF CONTACTS:

Daily contact with coding staff, physicians and Information Services staff.

Routine contact with requesters of data and reports.

Routine contact with other departments, physicians, Corporate Compliance Officer and Peer Review Organization.

Routine contact with coding system vendors, contract coding and review agencies.

Routine contact with HIM Coding educators.

Routine contact with HIM Coding Associate and/or coding students.

DIRECTION/SUPERVISION OF OTHERS:

Immediate Supervision: 2 Coding Coordinator V, 7 Coding Coordinator IV, 7 Coder Associates

Indirect Supervision: none

DIRECTION/SUPERVISION RECEIVED:

Immediate: Manager, Coding Data Management & Education, and Director, Coding and Compliance

Indirect: Director Coding and Compliance, HIMS

Department Head: Corporate Director, HIMS

EDUCATION AND EXPERIENCE REQUIREMENTS:

Associate degree in HIM or healthcare related field, required.

Bachelor's degree in HIM or healthcare related field, preferred.

One or two years of leadership experience, required.

Successful completion of CCHS Leadership classes, required within 12 months of hire/promotion into this role.

Five years coding education experience in acute care healthcare environment, required.

Demonstrated competence in all Inpatient and Outpatient general record types and 50% of all Inpatient and Outpatient specialty types, required.

Experience implementing and maintaining computer systems, preferred.

Experience with Project Management, preferred.

KNOWLEDGE, SKILL, AND ABILITY REQUIREMENTS:

Ability to work independently.

Extensive knowledge of medical terminology, anatomy, physiology, pharmacology, and disease processes.

Extensive knowledge of ICD and CPT coding nomenclature, UHDDS and general coding principles.

Extensive knowledge of Prospective Payment Systems and application.

Thorough knowledge of Encoding, Abstracting, and Hospital Information Systems.

Ability to effectively communicate and demonstrate strong leadership abilities.

Ability to work well with others on all levels, displaying diplomacy and tact.

Ability to utilize computer applications on various platforms.

SPECIAL REQUIREMENTS:

AHIMA: CCS, required.

AHIMA: RHIA or RHIT, preferred.

AHIMA: Inpatient or Outpatient Auditing Micro-credential, strongly preferred.

AHIMA: CDIP or ACDIS: CCDS within 12 months of hire/promotion into role.

AAPC: CIRCC within 18 months of hire/promotion into role.

Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.

Post End Date

EEO Posting Statement

ChristianaCare offers a competitive suite of employee benefits to maximize the wellness of you and your family, including health insurance, paid time off, retirement, an employee assistance program. To learn more about our benefits for eligible positions visithttps://careers.christianacare.org/benefits-compensation/